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S. is the issue of waiting times. Wait times for services are affected by several factors. Both countries are plagued by excessive wait times for certain services, such as specialists, surgery, or specialized treatments such as that for specific cancers or heart conditions. In both the United States and Canada, waiting times are determined in part by the number of providers available to provide that service in a certain geographic area. However, in the United States, wait times can be slowed by access to funding or the unwillingness of a provider to perform a certain service at the price set by the insurer, be it private or public. In Canada, price does not figure into the wait time. The urgency of the need of the person and the availability of services in a certain geographic area are the only factors that figure into the wait time.
Emergency room waits tend to be longer in Canada than in the U.S., averaging over 2 hours in Canada. Wait times for specialists largely depended on the specialty in both countries. In the U.S., low-income patients can wait three months or more to see specialists (Davis, Shoen, & Shoenbaum, 2007). Medicaid patients often have to wait longer because some doctors refuse to see Medicaid patients. In Canada, the average waiting time to see a specialist was a little over four weeks (Davis, Shoen, & Shoenbaum, 2007). Canadians had much less wait time to see a specialist than patients in the United States, particularly if the person happens to be a Medicaid recipient.
Both the U.S. And the Canadian healthcare systems have positive and negative aspects. The Canadian system regulates healthcare costs by being the sole purchaser of services. It does not allow private patients or insurance companies to bid for services at a higher price. This keeps the costs down. In certain provinces, private insurance is banned altogether, creating only one potential payee for services. The system in the United States is a market driven system. In order to promote this system, the government enacted rules that allowed Americans to establish healthcare savings plans that provided for tax incentives for those who chose to participate. However, in order to qualify, these persons must higher deductibles on their insurance.
The U.S. healthcare system shifts the burden from insurance providers onto the consumer, and from the government to the consumer. Theoretically, the individual has some influence over pricing and the availability of services in the United States. However, this influence is very small. Providers are still responsible for the prices that they charge and there is a declining portion of the population that is willing to pay their price. As a result, many go without the medical services that they need. In Canada, the subsidized system assures that every person has access to medical attention regardless of their ability to pay.
Canadians spend much less than Americans on healthcare than U.S. citizens, who must bear much of the burden themselves. Canadians enjoy longer lives and lower infant mortality rates than those in the U.S. However, in many cases, they must pay the price in longer wait times for necessary services. Wait times were found to be problematic in both the U.S. And in Canada. Wait times in both countries were dependent upon the availability of services within a particular service area. However, in the U.S., the ability to pay was considered in the wait time, where in Canada it was not. In Canada, the patient received services based on their medical need and on the number of physicians in the area for the desired specialty.
Even thought Canadians tended to have longer wait times for necessary medical procedures than those in the Unites States, at least they eventually received the necessary services. In the United States, the inability to pay can mean the inability to access services at all. For some, unless the condition necessitates an emergency medical condition in which the person is expected to deteriorate if they do not receive treatment, the provider has the right to refuse services due to the inability to pay.
When healthcare providers can determine who they wish to treat and who they do not, based on the patient's ability to pay, it creates a class system based on medical care. Those that can pay for medical care are classed differently than those that cannot. Those that can afford medical care constitute the wealthy class. Those on government-subsidized programs are of a lower socioeconomic status than those that can afford private medical insurance in the United States. This is not so in Canada, where everyone has the same chances to access healthcare as the wealthy class.
The medical system in the United States creates a division between those that can afford healthcare and those that cannot. Many Medicaid/Medicare recipients in the United States are stigmatized for being dependent on the government, and hence, the American public, for their healthcare services. This is not the case in Canada, where the right to basic healthcare is considered a basic human right and the right of every Canadian citizen. This point emphasizes the differences in philosophy between these two systems. The U.S. system could be criticized for creating a system that discriminates against the poor through their inability to access needed services.
Both the Canadian and U.S. systems have positive an negative aspects. The Canadian system provides equal access to healthcare services at the expense of the providers of such services. In the market driven system of the United States, physicians and providers have the ability to set higher and higher prices through the ability to deny services to those who cannot pay. Currently, this system has set up conditions where healthcare costs are spiraling out of control. In any other commodity, the inability to pay would force providers to lower their prices. However, in the case of the healthcare industry, normal economics do not necessarily apply. This is especially true when the necessary medical treatment can mean the life or death of the patient.
It is difficult to say whether the Canadian or the U.S. healthcare system is better. However, it appears that the Canadian system at least has the ability to stabilize the provision of healthcare services for its citizens. The current U.S. system creates the situation where rising prices will mean denial of services for a growing portion of its population. Neither system is perfect, but given the current state of the U.S. medical care system, the position that favors greater government control appears to be a logical answer to the healthcare crisis.
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